Long-acting coronary vasodilatory action of the molsidomine metabolite Sin I: a quantitative angiographic study

Abstract

The vasodilatory action of molsidomine was studied by intracoronary injection of its active metabolite, Sin 1. In 10 patients repeat coronary angiography in multiple projections was performed before and 2 minutes after administration of 1 mg of Sin 1, and before and after a second injection 60 minutes later. Contours of obstructed and non-obstructed segments of the left coronary artery were quantitatively analysed with a computer-based angiography analysis system. Immediately after its administration, Sin 1 increased the mean diameters of 44 normal coronary segments by 12% (P less than 0.001). Significant vasodilation (8%) was still observed after 60 minutes. At that time, repeated administration of Sin 1 increased the vasodilation by an additional 14% with respect to the control situation. An increase in obstruction diameter was observed in 6 out of 8 obstructed segments. Mean increase in the minimal obstruction diameter was still 10% after 60 minutes.

Molsidomine for the prevention of vasospasm-related delayed ischemic neurological deficits and delayed brain infarction and the improvement of clinical outcome after subarachnoid hemorrhage: a single-center clinical observational study

“…Surprisingly, we did not observe a significant alteration of blood flow velocities as measured by TCD, which we had expected as a potential side effect of molsidomine on the cerebral conductive vasculature. 25,27 The beneficial effect of molsidomine treatment on clinical outcome could be explained by its NO-related protective effect on the brain rather than as a therapeutic effect on vasospasm of the conductive vessels. This confirms the findings from the recently published cilostazol trial, in which an endothelial protective effect is attributed to elevating intracellular NO levels through the inhibition of phosphodiesterase 3 by using cilostazol.…”

“…7 An alternative NO donor with more favorable pharmacodynamic and pharmacokinetic profiles and less toxicity is molsidomine, a standard treatment for heart failure and coronary heart disease. 25,27 Thus, in this study, we used intravenously administered molsidomine as a rescue therapy in SAH patients with established CVS and observed its effect on the occurrence of DINDs, vasospasm-related infarcts, and clinical outcome.…”

Clinical outcome of acute myocarditis in children according to treatment modalities

“…Direct myocardial invasion by cardiotropic virus rapidly progress to the second phase of immunologic activation. The use of immunosuppression during acute viral myocarditis remains controversial3, 4). Lernel5-7) suggested that steroids be avoided at least during the first 10 days of acute infection because steroids inhibit interferon synthesis and increase viral multiplication in experimental coxsackievirus infection.…”

Intravenous immunoglobulin in the therapy of adult acute fulminant myocarditis: A retrospective study

“…The damage to the myocardium in AFM may be mediated by predominantly immunological mechanisms rather than by the direct effect of viral infection and replication (13,14). Previous studies have indicated the therapeutic effects of the IVIG in acute myocarditis (11,15).…”